Healthcare Provider Details

I. General information

NPI: 1467473553
Provider Name (Legal Business Name): ATLANTIC CLINIC CENTER, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/22/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1800 W 68TH ST SUITE 117
HIALEAH FL
33014-4404
US

IV. Provider business mailing address

1800 W 68TH ST SUITE 117
HIALEAH FL
33014-4404
US

V. Phone/Fax

Practice location:
  • Phone: 305-556-9550
  • Fax: 305-556-9551
Mailing address:
  • Phone: 305-556-9550
  • Fax: 305-556-9551

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0400X
TaxonomyRehabilitation Clinic/Center
License NumberHCC5154
License Number StateFL

VIII. Authorized Official

Name: SANDRA PILOTO CINTRA
Title or Position: PRESIDENT
Credential:
Phone: 786-281-9250